PATENT APPLICATION FEE DETERMINATION RECORD
Effective October 1 , 2001
Application or Docket Number
CLAIMS AS FILED • PART I
TOTAL CLAIMS
FOR
NUMBER FILED
NUMBER EXTRA
TOTAL CHARGEABLE CLAIMS
% minus 20=
* CP
INDEPENDENT CLAIMS
3 minus 3 =
MULTIPLE DEPENDENT CLAIM PRESENT
□
SMALL ENTITY
TYPE I 1
OTHER THAN
OR SMALL ENTITY
CLAIMS AS AMENDED- PART II (oj j^jc^
RATE
FEE
I RATE
FEE j
BASIC FEE
370.00
OR
BASIC FEE
740,00 |
X$9=
OR
X$18=
X42«
OR
X84=
♦140=
OR
+280=
„ TOTAL
OR TOTAL I
IENTA I
I 1 tuwtr-
REMAINING
AFTER
AMENDMENT
» HIGHEST
NUMBER
| PREVIOUSLY
PAID FOR
l^uiuinn oi
PRESENT
EXTRA
Sfe
O
Z
Total
Minus
Ul
S
Independent
^ 3
Minus
*** <L
<
FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM
LLJ
(Column 1*
(Column 2)
(Column 3)
I ENTB
[ CLAIMS
| REMAINING
AFTER
AMENDMENT
HIGHEST
NUMBER
PREVIOUSLY
PAID FOR
PRESENT
EXTRA
o
z
Total
*
Minus
**
s
UJ
s
Independent
Minus
***
<
FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM
n
(Column 1)
(Column 2)
(Column 3)
lENTC
CLAIMS |
REMAINING
AFTER
AMENDMENT
HIGHEST
NUMBER
PREVIOUSLY
PAID FOR
PRESENT
EXTRA
Q
Z
Total
*
Minus
**
a
Ul
s
Independent
*
Minus
<
FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM
n
OTHER THAN
SMALL ENTITY OR SMALL ENTITY
• If the entry in column 1 is less than the entry in column 2. write "0* in columns.
** If the 'Highest Number Previously Paid For* IN THIS SPACE is less than 20. enter "2
—*f the "Highest Number Previously Paid For* IN THIS SPACE is less than 3, enter "3/
The 'Highest Number Previously Paid For* (Total or Independent) is the highest number found in the appropriate box in column 1
RATE
ADDI-
TIONAL
-FEE
RATE
ADDI-
TIONAL
FEE
X$9=
OR
X$18=
X42=
OR
X84=
+140=
OR
+280=
TOTAL
ADO IT. FEE
OR
■'toTaT
ADDfT. FEE
RATE
ADDI-
TIONAL
FEE
RATE
ADDI-
TIONAL
FEE (
X$9=
OR
X$18=
X42=
OR
X84=
+140=
OR
+280=
TOTAL
ADDfT. FEE
OR TOTAL
RATE
ADDI-
TIONAL
FEE
RATE
ADDI- I
tionalI
FEE 1
X$9=
OR
X$18=
X42=
OR
X84=
+140=
OR
+280=
TOTAL
ADOPT. FEE
no TOTAL
Aoorr. FEE
FORM PT0*73 (Rev. 8/01}
Patent and Trademark Office, U.S. DEPARTMENT OF COMMERCE